Valerie Vaz - Department of Health and Social Care debates

Health and Social Care (Re-committed) Bill

Valerie Vaz Excerpts
Tuesday 6th September 2011

(13 years, 4 months ago)

Commons Chamber
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Mark Simmonds Portrait Mark Simmonds
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I shall finish this point, and then I will happily give way to the hon. Gentleman, because he was extremely generous in giving way. Let me summarise the Government’s motivation in five areas. The first is to improve patient care; the second is to drive up the quality of services; the third is to improve patient outcomes; the fourth is to ensure better value for taxpayers’ money; and the fifth, and perhaps most important, is to ensure that our much-loved national health service has a successful future as a service that is free at the point of need, and a service that is based on requirement, not ability to pay. There should be continued equity of access and, even more importantly, excellence for all.

With the honourable exception of the hon. Gentleman’s contribution, all the contributions from Labour Members, including those on the Front Bench, have completely misrepresented the Bill. There is a degree of complacency creeping into the Labour party. The view that it puts forward—that there is nothing wrong with the national health service, and that it is a perfect, utopian service—is clearly not correct. Its view that no reform or innovation is required is not correct. Its view that no productivity improvements can be made is clearly not correct. The view that there is no problem with patient outcomes across a whole range of clinical indicators compared with the outcomes in our developed-world comparators is clearly not correct. The Labour party’s view that there is no need to reduce the cost of administration and get more resources to front-line patient care is clearly not correct; nor is it correct that there is no need for greater clinical involvement in commissioning and for greater patient choice. The Labour party’s position is purely political. It is not clinical and it does not have the best interests of patients at heart. I urge the Secretary of State and his ministerial team to reject the amendments tabled by Labour.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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Does the hon. Gentleman recall these words—“NHS” and “no top-down reorganisation”, said by one David Cameron, leader of the Conservative party?

Mark Simmonds Portrait Mark Simmonds
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I do remember that. The changes outlined in both the original Bill and the amendments that have been tabled as a result of the considered and very professional work of Professor Field and his team demonstrate the desire of the coalition Government to make sure that the national health service survives for future generations as a taxpayer-funded service free at the point of need. All the changes set out in the Bill are determined by that.

The hon. Member for Leicester West (Liz Kendall), who spoke for Labour in the programme motion debate, should be wary of praying in aid the BMA. Not only did it object back in the 1940s to the setting up of the national health service, but just prior to the last election, it said that the Labour party was the enemy of the national health service. We need to engage with all the clinical groups within the national health service to ensure that we deliver the best possible patient outcomes for the amount of resources that we can put in.

I am slightly surprised at the repetitive nature of the debate. I have been told by my hon. Friends who sat on the Bill Committee that many of the points that were made in Committee have been made again today. The Government amendments that we are discussing are a direct result of the forum chaired by Professor Steve Field. I thought it unedifying of the right hon. Member for Holborn and St Pancras (Frank Dobson) to try to undermine Professor Field, who does excellent work in a very socio-economically deprived part of Birmingham. If the right hon. Gentleman has not visited Professor Field and seen the excellent work that he does, I suggest he does so.

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Dan Poulter Portrait Dr Poulter
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No, sit down. The hon. Lady should listen to this, because it is important. The point is that doctors and nurses need to be allowed to get on and do their jobs.

A key focus is not just about putting more money into front-line patient care but making sure that we have clinical leadership of services. Form-filling for the sake of it does not benefit patients; what benefits patients is allowing doctors to treat those in front of them. Under the perverse incentives that were created previously, the four-hour wait in A and E means that a patient with a broken toe is just as much of a priority as someone with potentially life-threatening chest pain. That is the problem with the service that we have, and that is why the clinical leadership and focus that this Bill is bringing will be so important.

Valerie Vaz Portrait Valerie Vaz
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Dan Poulter Portrait Dr Poulter
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I am going to make a little progress. Other speakers want to contribute, so I hope that the hon. Lady will forgive me for not taking her intervention.

The Bill focuses on integration and looks to improve the care particularly of our frail elderly. There is too much silo working in the health service—in primary care, in secondary care and in adult social services. The Bill seeks to integrate services through the role provided by Monitor in helping to provide an overarching view of value for the patient and through the setting up of health and wellbeing boards at local level. That is intended to provide better integration of adult social care with NHS care, which has not happened in all parts of the country.

The hon. Member for Easington made a very good speech in which he said that care was hugely variable throughout different parts of England. That is because in many areas we do not have properly joined-up thinking about how things are done. For example, hospitals are paid on payment by results, but there is no incentive necessarily to reduce admissions and to provide much more focused community care, which would be so important in improving the care of the frail elderly in their communities and in their homes. The Bill is starting to take the first steps towards that sort of joined-up thinking.

If Labour Members are concerned about this, the point was well made by Lord Warner in his recent comments as part of the Dilnot report. The right hon. Member for Holborn and St Pancras (Frank Dobson) laughs, but he served alongside Lord Warner in the previous Government.

Oral Answers to Questions

Valerie Vaz Excerpts
Tuesday 12th July 2011

(13 years, 5 months ago)

Commons Chamber
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Simon Burns Portrait Mr Burns
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As the right hon. Gentleman will know, the access measures concerning people being able to see their GP within a reasonable period of time are set out in the quality and outcomes framework. The evidence that I have seen certainly shows that our approach is generally working very well, although there are variations in different parts of the country, especially London, where I believe there is scope for improvement.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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5. What discussions he has had with the Chancellor of the Exchequer on the cost to the public purse of NHS reorganisation arising from the proposed changes to the Health and Social Care Bill.

Simon Burns Portrait The Minister of State, Department of Health (Mr Simon Burns)
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The Treasury had sight of the impact assessment published alongside the Health and Social Care Bill, which estimated savings of about £5 billion by 2014-15, and £1.7 billion a year thereafter. A revised impact assessment will be published as the Bill progresses.

Valerie Vaz Portrait Valerie Vaz
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I thank the Minister for his helpful answer. Given that there are to be new structures—the NHS commissioning board, the clinical senates, the local commissioning groups and Public Health England—will there be new money for them, or will the money come out of the allocated budget?

Simon Burns Portrait Mr Burns
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I thank the hon. Lady for her helpful question. As she will appreciate, the money will come out of the existing allocations, but what she needs to understand is that as a result of this, and as a result of improving and cutting out wasteful inefficiencies and bureaucracy, we will actually be saving significant sums. Administration will be cut by a third, so that we can invest all the savings in front-line services.

NHS Future Forum

Valerie Vaz Excerpts
Tuesday 14th June 2011

(13 years, 6 months ago)

Commons Chamber
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Lord Lansley Portrait Mr Lansley
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Yes, my hon. Friend makes an important point. If we had listened to the Labour party last year, we would have cut the NHS and would not have increased the resources going into it. The £20 billion efficiency savings required to respond to demand and cost would have been £30 billion, which would have put an unsupportable degree of pressure on the NHS. As it is, we are giving the NHS not only resources but the opportunity to deliver improving care.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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After the White Paper was published in July last year, 6,000 representations were received from health professionals and from the Select Committee on Health asking the Secretary of State to think again about breaking up the NHS, so this “listening exercise” has been a waste of public money. Either the Secretary of State was wrong then, or he is wrong now. Which is it?

Lord Lansley Portrait Mr Lansley
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I am afraid I have to say that that was all nonsense. As the hon. Lady knows, we responded positively to the consultation last year and made changes then. However, as the details of the Bill have been emerging, people have been trying to work out how they will make it all work in the future. They have been saying, “We want to set out in the legislation precisely how it will work.” There is no better way of making that process effective than talking to people in the NHS, engaging with them, listening to them, and then implementing the changes.

Oral Answers to Questions

Valerie Vaz Excerpts
Tuesday 7th June 2011

(13 years, 7 months ago)

Commons Chamber
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Lord Lansley Portrait Mr Lansley
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I am sure that my hon. Friend is aware of the evidence—for example, in reports published by the London School of Economics and by Imperial college, London—on this country’s experience of the Labour party’s implementation of choice in elective care and the impact that had on the quality of services. What is clear from that evidence is that where there was an NHS price—a tariff structure—the more competitive areas of the country secured greater improvements in quality.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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I thank the Secretary of State for writing to me on 12 May about the listening exercise and its cost, although he could not quantify that. Now that the listening exercise is over, can he say how much the cost to the public purse has been?

Lord Lansley Portrait Mr Lansley
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I will, by all means, write again to the hon. Lady. The cost is not dramatic. Many organisations and people across the NHS have participated, giving freely of their time. Some 8,000 people have participated in the listening exercise events, of which there were more than 250. This has been immensely valuable; its value far exceeds any costs involved.

Future of the NHS

Valerie Vaz Excerpts
Monday 9th May 2011

(13 years, 8 months ago)

Commons Chamber
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Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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It is always a pleasure to follow the hon. Member for Totnes (Dr Wollaston) and to serve with her on the Select Committee on Health.

I welcome this debate, which is the first chance that the House has had to debate the NHS after the pause—the listening, reflecting and engaging exercise—since Second Reading of the Health and Social Care Bill. Something about this debate made me think of the words of The Beatles song “Hello, Goodbye”. Madam Deputy Speaker, you can imagine the discussion in No. 10 between the Secretary of State for Health and the Prime Minister: “You say stop, I say go. You say, ‘Why?’ I say, ‘I don’t know.’” I promise it sounds better when sung. We can see now why The Daily Telegraph said this Saturday that the Secretary of State was to get first aid from the No. 10 spin doctors.

It is right that the Government should take on board the voices in this House and outside—those of the experts, the patients, our constituents—not in reselling their proposals, but in fundamentally changing them. I wish to cover three main areas: accountability, costs and other concerns. On accountability, as a member of the Health Committee, which is so ably chaired by the right hon. Member for Charnwood (Mr Dorrell), we have heard evidence from expert after expert—from the BMA, which I promise was not whingeing, to GPs, nurses and public health clinicians—all of whom expressed concerns about the lack of detail on the ideas in the White Paper. Matters did not become much clearer even on Second Reading.

Our latest report, “Commissioning: further issues”, published on 5 April, said that there should be no doubt that the Secretary of State has ultimate responsibility, but that is not clear from the Bill. We have concerns about accountability and the governance arrangements for the consortia that will be responsible for £60 billion of public money, but that issue is not clear in the Bill. There are concerns that private and voluntary providers will not be covered by the Freedom of Information Act 2000, which is not dealt with in the Bill either. Concerns remain about conflicts of interest in respect of GPs who are commissioners and providers, but that is not clear in the Bill.

Some PCTs were working with clinicians to provide a more integrated service. A more evolutionary and cost-effective approach would be to remove the non-executive directors of the PCT boards and replace them with GPs. That would have been not a top-down reorganisation, but a progressive and less disruptive approach.

I am staggered by the uncertainty surrounding how much this reorganisation will cost the taxpayer. The proposals in the White Paper were neither costed nor explained, and the spending is not committed, so it must come out of revenue. Professor Kieran Walshe, of Manchester Business School, put the cost at £2 billion to £3 billion, but the Government’s figure is £1.4 billion. The redundancy costs alone amount to £852 million. Sir David Nicholson said that the running-cost envelope was £5.1 billion for the running of the current service and the development of the consortia. In an written parliamentary answer to me, the Minister said that the spend and operational arrangements of pathfinder consortia are not being monitored. That smacks of fiscal incompetence and a Department that has lost control of its budget. It is so out of control that the head of Monitor wrote to foundation trusts, telling them that the NHS must find savings of 6.5% rather than 4%. That is an extra £1.1 billion on top of the savings demanded by the Department.

Members will be interested to know that the head of Monitor compared the NHS under the Government’s proposals to privatised utilities. Does Ofgem have trouble regulating the utilities? It was ineffective in dealing with companies’ unfair pricing practices and companies that made large profits during the recent severe weather.

Lilian Greenwood Portrait Lilian Greenwood (Nottingham South) (Lab)
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Does my hon. Friend agree that the Government’s plan to abolish the cap on income from private patients is a real concern when hospitals are starved of cash, because it could result in them putting private, fee-paying patients ahead of NHS patients?

Valerie Vaz Portrait Valerie Vaz
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I absolutely agree with my hon. Friend.

We were told by Sir David Nicolson that very little work has been done on what will happen in 2013-14. Just for the record, the UK had the second-lowest debt in the G7 in 2007-08, before the global financial crisis. Which Government are out of control with their spending?

Finally, there are many unanswered questions. I have tried to obtain the legal advice on whether EU competition law applies to the provisions of the Bill from the Secretary of State, but apparently, it is in the public interest not to disclose that to the public. However, in a recent article in the British Medical Journal, Rupert Dunbar-Rees, a GP, and Robert McGough, a solicitor, say that

“the technical argument reinforces the logical argument that the reforms further open up the NHS to EU competition law.”

Who will account for the training of doctors, and indeed health care professionals? That cannot be left at a local level. In A and E, an increased percentage of patients wait more than four hours, the maternity service in Maidstone has been closed despite GP opposition—

Baroness Primarolo Portrait Madam Deputy Speaker (Dawn Primarolo)
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Order. I am very sorry to interrupt the hon. Lady, but the clock is not correct. If she is following that, she will not know that she does not have that much time left—the clock stopped and did not start again. I would advise her to take about another minute and a half only.

Valerie Vaz Portrait Valerie Vaz
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At Barts specialist regional cancer care unit, 20% of staff have been cut in two weeks.

An Ipsos MORI poll found that 71% agree that the NHS is the best in the world and that 72% express satisfaction with the NHS, but that was published by the Department only under pressure.

Finally, there have been 6,000 responses to the White Paper. The people of England have given their proposals, but they have not given their verdict on the Bill. They want the Prime Minister to keep his promise. If he does not do so, they will be ready to give their verdict at the next general election.

None Portrait Several hon. Members
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Oral Answers to Questions

Valerie Vaz Excerpts
Tuesday 26th April 2011

(13 years, 8 months ago)

Commons Chamber
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Lord Lansley Portrait Mr Lansley
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That, indeed, will be one of the areas on which the quality and outcomes framework for individual GP practices will focus. In addition, however, through the commissioning outcomes framework for the NHS as a whole, one area in which we want to see continuing improvement in quality is patient experience and outcomes as reported by patients. GPs and their clinical colleagues will therefore be incentivised continuously to improve quality.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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Can the Secretary of State tell us how much this consultation exercise is costing the public purse?

Lord Lansley Portrait Mr Lansley
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No, I cannot, but I will write to the hon. Lady.

NHS Reform

Valerie Vaz Excerpts
Monday 4th April 2011

(13 years, 9 months ago)

Commons Chamber
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Lord Lansley Portrait Mr Lansley
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Yes, I agree. Indeed, in north-east Essex, the consortium under Dr Shane Gordon’s leadership is doing exactly that. I personally think that leadership and listening are not mutually exclusive, and we are going to continue to do both.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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In the spirit of openness, will the Secretary of State please place in the House of Commons Library a copy of the legal advice on whether EU competition law will apply to the provisions in the Bill?

Lord Lansley Portrait Mr Lansley
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The hon. Lady should know, as a member of the Health Select Committee, that I wrote to the Chair of the Committee just last week and set out the position very fully. The Bill does not extend the scope or application of competition law at all.

Oral Answers to Questions

Valerie Vaz Excerpts
Tuesday 8th March 2011

(13 years, 10 months ago)

Commons Chamber
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Lord Lansley Portrait Mr Lansley
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Local attention, through the public health responsibilities that currently lie with PCTs, but which in future will lie with local authorities, is a means by which we can improve health and the health of some of the groups most at risk of HIV. We have a number of pilot schemes that my hon. Friend might know about and that we are currently assessing, which have looked at opportunistic HIV screening for the many people who are currently undiagnosed with HIV. That is encouraging, and we might well be able to follow up on it.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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T10. Given that the chief medical officer does not have a background in public health, and despite the existence of Public Health England, should the Secretary of State not ensure that there is a public health expert on the national commissioning board, because that is where all the power lies?

Lord Lansley Portrait Mr Lansley
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I am surprised, because the hon. Lady is on the Select Committee on Health and should know that responsibility for public health will lie both with Public Health England, inside the Department of Health, and with local authorities. The NHS commissioning board will have a responsibility for prevention, but the population health responsibility will lie with Public Health England, and I have absolute confidence that Dame Sally Davies, the newly appointed chief medical officer, will be a leader in public health delivery, through Public Health England.

Swine Flu

Valerie Vaz Excerpts
Monday 10th January 2011

(14 years ago)

Commons Chamber
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Lord Lansley Portrait Mr Lansley
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I am grateful to my hon. Friend for that question. His local hospital, the Glenfield in Leicester, leads on specialised ECMO bed services. In this country, we have increased the number of ECMO beds; we have more per head of population than any of the developed health economies, including the United States. As for treatments and vaccinations, I continue to rest upon the scientific and expert advice. Indeed, I hope that patients will consult their clinicians about their treatments.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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Will the Secretary of State say whether he took the decision to delay the advertising campaign and, if so, when?

Oral Answers to Questions

Valerie Vaz Excerpts
Tuesday 2nd November 2010

(14 years, 2 months ago)

Commons Chamber
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Lord Lansley Portrait Mr Lansley
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I am grateful to my hon. Friend. He knows that the criteria that I set out, which were repeated earlier during questions, must be applied, not only to the strategies that were previously presented, but to potential new strategies that Barnet and Chase Farm hospitals might wish to present, in order to ensure that GP commissioning intentions, future patient choice and public views are properly reflected.

Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
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Many of my constituents are being offered the swine flu vaccine in combination with the seasonal flu vaccine. Will the Secretary of State ensure that they have the choice to have those vaccines separately?

Lord Lansley Portrait Mr Lansley
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The hon. Lady will forgive me, but I do not propose to make that available, as it would be a great deal more expensive. Each year, and on an international basis, the World Health Organisation advises on what the seasonal flu vaccine should consist of, and it almost always consists of the three most likely strains combined together into one vaccine.